Pathologists Are From Mars, Hepatologists Are From Venus: Decoding Steatotic Liver Disease

Description

The clinical significance of findings in liver biopsies exhibiting steatotic liver disease (MASLD, MetALD, MASH) are the focus of this session. Presentations and discussion examine some of the interpretive issues that pertain to the new steatotic liver disease category MetALD, ie, whether it is feasible to distinguish contribution or features of alcohol-related findings from MASLD only or MASH only. Metabolic diseases (eg, Wilson disease or alpha-1 antitrypsin deficiency) and DILI with a steatohepatitic pattern (eg, methotrexate) are discussed with an emphasis on distinguishing these entities from other categories of steatotic liver disease. In addition to pathology, the session highlights the importance of utilization of pathology reports to facilitate diagnosis and further work-up, and the utility and limitations of liver biopsy to narrow a differential diagnosis. Case presentations illustrate the importance of clinicopathologic correlation in different clinical settings.